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Your guide to preventing heartburn

November 23, 2016 | UCI Health
man eating and having heartburn

The only things that should linger after festive meals and parties are good memories. But for too many people, heartburn settles in soon after the consumption of rich food and drinks, leading to sleepless nights and days of pain and burning in the chest or throat.

Reduce your heartburn risk

You can minimize the risk of heartburn and manage the symptoms more effectively with a little strategizing, says Dr. Robert H. Lee, director of gastrointestinal (GI) motility services with the UCI Health Digestive Health Institute.

And, you will be happy to know that preventing heartburn doesn't mean having to give up your favorite foods.

Persistent heartburn is also known as gastroesophageal reflux disease, or GERD. It's caused by acid that splashes up from the stomach into the esophagus.

GERD is the term used to describe heartburn that occurs at least once a week. According to a recent study, GERD affects 20 percent of the U.S. adult population weekly and about 7 percent daily.

Avoiding certain foods doesn't help

Some of the advice and recommendations about preventing and treating GERD has changed in recent years, Lee notes. For example, avoiding certain foods probably won't make much of a difference in preventing symptoms.

"We used to say don't drink coffee or alcohol or eat peppermints or spicy foods," he says.

"But most of the large studies have documented that that advice is really not valid."

It's also untrue that the GERD can be treated with products, such as alkaline water, to "restore" the proper acidity in your body, he says.

How to minimize GERD symptoms

But there are a few things that will likely reduce GERD symptoms:

  • Stop smoking. Smoking makes reflux worse.
  • Avoid eating close to bedtime. "Don't eat within the three hours prior to bedtime and then lie flat," he says. Instead, sleep with your upper torso raised a few inches to inhibit the acid from flowing back into the esophagus.
  • Lose weight if you're overweight. Studies show GERD is closely associated with obesity. Even a loss of 10 to 15 pounds may alleviate your symptoms, Lee says.

Most people with occasional heartburn find relief with an over-the-counter medication, such as a proton pump inhibitor. But Lee adds: "About 10 percent of people don't get better with over-the-counter remedies. People should come to see us when they have severe symptoms that don't get better with medications and when there are some other red-flag symptoms."   

Symptoms of a serious condition

You may have a more serious condition if you have other symptoms such as:

  • Difficulty swallowing
  • Weight loss
  • Getting full easily
  • Blood in the stool
  • Vomiting blood

Chronic GERD can also lead to a precancerous condition called Barrett's esophagus.

When to call a specialist

"It's pretty common for people to wait too long to see a doctor; they just put up with their symptoms," Lee says. "But if you have five years' worth of symptoms, you're at risk of developing Barrett's esophagus."

For Barrett's esophagus, doctors examine the esophagus and monitor changes. If treatment is needed, radiofrequency ablation therapy is often used to deliver radio waves through a catheter into the esophagus to destroy diseased tissue.

People with chronic GERD who aren't helped by standard medications can undergo testing to help doctors figure out why the reflux is occurring. UCI Health doctors perform two types of tests — called 48-hour wireless pH testing and 24-hour pH impedance testing — that can yield useful information to better tailor the patient's treatment.

Caution using proton pump inhibitors

Lee cautions patients regarding the use of proton pump inhibitors (PPIs). Over the past decade, the Food and Drug Administration has issued warnings linking high doses and long-term use of proton pump inhibitors to an increased risk of bone fractures and a gastrointestinal infection called Clostridium difficile.

Recent studies also have suggested links to kidney and heart disease. PPIs can also interfere with some prescription medications. See: Should you continue taking acid reflux medication? ›

"The bottom line with PPIs, as with any medication, is that you have to weigh the risks with the benefits," Lee says. "If you stop taking the medication and your quality of life is horrible, the benefits are probably worth the risks."

Acid reflux treatment options

GERD can also be successfully treated by several minimally invasive techniques. These procedures allow you to drastically reduce or, more often, totally eliminate medications. Depending on the type of GERD, treatment options may include:

  • EsophyX TIF™: TIF, which stands for transoral incisionless fundoplication, uses a special scope and camera inserted through the mouth. The procedure elongates the esophagus and tightens the sphincter valve to keep stomach acid from splashing up. It is done under anesthesia and takes about an hour. Patients spend one night in the hospital and resume normal activities in a couple of days.
  • LINX: This procedure surgically implants a special magnetic ring around the esophagus, just above the stomach. The magnetic ring strengthens the function of the sphincter. Swallowing breaks the magnetic bond so food and liquid pass normally into the stomach. After swallowing, magnetic attraction brings the beads back together to prevent stomach acid and contents from splashing back into the esophagus.
  • MUSE™: This technique, short for Medigus Ultrasonic Surgical Endostapler, uses a single instrument inserted through the mouth to allow surgeons to repair the sphincter. The procedure, performed under general anesthesia, takes about 60 to 90 minutes and provides relief from GERD.
  • Stretta: This procedure is ideal for people with a mild form of GERD, such as those who have reflux only during the day. It involves endoscopically administering radiofrequency energy to a patient’s sphincter to bulk it up and increase its effectiveness.

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